Interventions to reduce risky sexual behaviour for preventing HIV infection in workers in occupational settings

Background: HIV in the workforce has a negative impact on economic growth and development of affected countries. The workplace provides an important avenue to prevent HIV by providing easy access to workers who might have similar high risk sexual behaviour because of the nature of their work. Objective of this systematic review is to evaluate the effect of behavioural interventions on high risk sexual behaviour to prevent HIV among workers. Methods: We searched electronic databases to locate studies. Only randomised control studies in occupational settings or among workers identified as high risk groups were included. The outcome measures were: indicators of high risk sexual behaviours, uptake of Voluntary Counselling and Testing (VCT), and incident cases of HIV. We excluded health workers, sex workers, injection drug users and Men who have sex with men because these are already in other reviews. Results: We included 4 studies but we had incomplete data from one. All the studies were from developing countries in Asia and Africa with a total of 7994 participants. We grouped the studies in the following comparisons: Uptake of VCT was increased when provided in workplace compared to voucher for testing only, RR=14.0 (95% CI 11.8 to 16.7), HIV incidence was not reduced, RR=1.4 (95% CI 0.7 to 2.7). Education caused a non-significant decrease in sex with extra partner RR=0.7 (95% CI 0.3 to 1.8) and unprotected sex, RR=0.9 (95% CI 0.5 to 1.4). More intensive Information, motivation and behavioural (IMB) skills training increased the use of condom, RR=2.8 (95% CI 1.6 to 4.1) and decreased sex with commercial sex workers, RR=0.8 (95% CI 0.80 to 0.96) in a very high risk group of truck drivers. Conclusion VCT might not be effective in reducing HIV incidence in workplace intervention, and delivering voluntary counselling and testing on-site at workplace increases the uptake of VCT. However, education, and Information, motivation and behavioural (IMB) skills training might be worthwhile in reducing risky sexual behaviour and increasing condom use, especially when delivered with high intensity in the workplace.

• Determinants of Health
  • Employment
• Population(s)
  • General HIV- population
  • Other
• Prevention
  • Sexual risk behaviour
  • Education/media campaigns